Staten Island — NYPD HEALTH AND WELLNESS SECTION

Registration and Release form.

Below is the registration for the 122 Precinct Beach Yoga Event taking place on Wednesday July 30, 2025.The event will take place on the beach at Sand Lane at Fr Capodanno Blvd (The Dolphins) in the confines of the 122 Precinct from 0700 x 1000 Hours. By completing the registration below you agree to review the following two documents by clicking/tapping and reading each one. The info will be collected below after reading the documents:

Yoga Class Waiver

Photo Release Waiver

Person Registering for Event

First Name

Last Name

Event Participant (Same as above if age 18 and over)

First Name

Last Name

Department Email

Phone

(###)

###

####

Tax Number

Command Name if MOS, Full Address if Non MOS

Tour Working on Wednesday July 30, 2025 (If RDO put RDO)

Electronic Signature, By typing your name below and by completing this digital form I acknowledge both release forms above and agree to register and participate. If I am registering on behalf of someone under the age of 18, I am acknowledging and am responsible for both release forms above as their parent/custodian/guardian:

Registration and Release form.

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